Diş eti fenotipi ve alveolar kemik morfolojisi arasındaki ilişkinin değerlendirilmesi

Year 2019, , 6 - 13, 31.03.2019

Esra Ercan , Elif Bilgin Saliha Koprucu , Saadettin Kayipmaz

https://doi.org/10.33204/mucosa.537697

Cited By: 1

Abstract

Amaç Son yıllarda diş hekimliği alanında, diş eti fenotipinin belirlenmesi oldukça önem kazanmıştır. Ayrıca kemik ve

diş eti ilişkisi, pek çok tedavinin başarısını doğrudan etkilemektedir. Bu çalışmanın amacı, diş eti çekilmeleri, fenotipi

ile destek alveoler kemik kalınlığı arasındaki ilişkinin araştırılmasıdır.

Yöntem Bu çalışmada üst-alt kesici ve kanin olmak üzere toplam 207 dişe ait son 3 ayda çekilen konik ışınlı bilgisayarlı

tomografi görüntüsü üzerinde gerçekleştirilen radyolojik ölçümler ile klinik periodontal parametreler ve diş eti

fenotiplerinin birbirleriyle ilişkileri incelendi. Diş eti fenotipi, yeni geliştirilmiş Hu-Friedy Colorvue® fenotip sondu

ile “ince” / “orta” / “kalın” olarak belirlendi. Klinik periodontal parametreler, keratinize doku genişliği ve çekilme

derinliği değerleri kaydedildi. Bukkal kemik kalınlığı, konik ışınlı bilgisayarlı tomografi görüntüsü üzerinde,

krestal 1, 2 ve 4 mm seviyelerinden olmak üzere üç noktadan ölçüldü.

Bulgular Gruplar arası karşılaştırma sonuçlarına göre, ince fenotipte keratinize doku genişliği ve üç seviyedeki

kemik kalınlıkları kalın fenotipe göre istatistiksel olarak anlamlı derecede daha az bulundu (p<0.016). Orta

fenotipte ise krestal 2 ve 4 mm’de kemik kalınlığı kalın fenotipe göre istatistiksel olarak anlamlı derecede daha

az bulundu (p<0.016). Ayrıca diş eti çekilmesi ile krestal 2 ve 4 mm seviyelerindeki kemik kalınlıkları arasında

negatif korelasyon görüldü (p<0.05).

Sonuçlar Bu çalışmanın sonucunda, diş eti fenotipi ile bukkal alveoler kemik kalınlığı arasında anlamlı pozitif

korelasyon olduğu ve kemik kalınlığı miktarının diş eti çekilmesi üzerinde etkili olabileceği söylenebilir.

Keywords

konik ışınlı bilgisayarlı tomografi, alveolar kemik, diş eti fenotipi

Evaluation of the relationship between gingival phenotype and alveolar bone morphology

Abstract

Objective In recent years, the determination of gingival phenotype has gained importance in the field of dentistry.

Bone and gingival relationship may directly affect the success rate of treatment modalities. The aim of this study is to

evaluate the relationship between gingival phenotype and underlying alveolar bone thickness.

Methods In this study, we investigated the relationship between the clinical periodontal parameters and gingival phenotypes

on the cone beam computed tomography (CBCT) image taken in the last 3 months of a total of 207 teeth.

The gingival phenotype was identified as “thin” / “medium” / “thick” with the newly developed Hu-Friedy Colorvue

® phenotype probe. Clinical periodontal parameters, width of keratinized tissue and gingival recession values

were recorded. Buccal bone thickness was measured at three points, as crestal 1, 2 and 4 mm. on CBCT images.

Results According to the results, in thin phenotype, width of keratinized gingiva and bone thickness at three levels

was found significantly lower than thick phenotype (p<0.016). In medium phenotype bone thickness at crestal 2 and

4 mm were found to be significantly less than the thick phenotype (p<0.016). Additionally a negative correlation was

seen between gingival recession and bone thickness at crestal 2 and 4 mm levels (p<0.05).

Conclusions We observed that there was a significant positive correlation between the gingival phenotype and buccal

alveolar bone thickness. We suggest that the amount of bone thickness may be effective on ginigval recession.

Keywords

cone-beam computed tomography, alveolar bone, gingiva

References

• 1. Seibert J, Lindhe J. Textbook of clinical periodontology. Copenhangen, Denmark: Munksgaard International Publishers; 1989.
• 2. Kao RT, Fagan MC, Conte GJ. Thick vs. thin gingival phenotypes: a key determinant in treatment planning for dental implants. J Calif Dent Assoc 2008;36:193-8.
• 3. Nikiforidou M, Tsalikis L, Angelopoulos C, et al. Classification of periodontal phenotypes with the use of CBCT. A cross-sectional study. Clin Oral Investig 2016;20:2061-71.
• 4. Fu JH, Yeh CY, Chan HL, et al. Tissue phenotype and its relation to the underlying bone morphology. Journal of periodontology 2010;81:569-74.
• 5. Verdugo F, Simonian K, Nowzari H. Periodontal phenotype influence on the volume maintenance of onlay grafts. J Periodontol 2009;80:816-23.
• 6. Cook DR, Mealey BL, Verrett RG, et al. Relationship between clinical periodontal phenotype and labial plate thickness: an in vivo study. Int J Periodontics Restorative Dent 2011;31:345-54.
• 7. Zuiderveld EG, den Hartog L, Vissink A, Raghoebar GM, Meijer HJ. Significance of buccopalatal implant position, phenotype, platform switching, and pre-implant bone augmentation on the level of the midbuccal mucosa. Int J Prosthodont 2014;27:477-9.
• 8. Alpiste-Illueca F. Dimensions of the dentogingival unit in maxillary anterior teeth: a new exploration technique (parallel profile radiograph). Int J Periodontics Restorative Dent 2004;24:386-96.
• 9. Barriviera M, Duarte WR, Januario AL, Faber J, Bezerra AC. A new method to assess and measure palatal masticatory mucosa by cone-beam computerized tomography. J Clin Periodontol 2009;36:564-8.
• 10. Kan JY, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans. J Periodontol 2003;74:557-62.
• 11. Muller HP, Schaller N, Eger T, Heinecke A. Thickness of masticatory mucosa. J Clin Periodontol 2000;27:431-6.
• 12. Kloukos D, Koukos G, Doulis I, et al. Gingival thickness assessment at the mandibular incisors with four methods. A cross-sectional study. J Periodontol 2018;89:1300-9.
• 13. Zigdon H, Machtei EE. The dimensions of keratinized mucosa around implants affect clinical and immunological parameters. Clin Oral Implants Res 2008;19:387-92.
• 14. Unal G, Aksakalli, S. Ortodontik Tedavi ve Diseti. Ataturk Universitesi Dis Hekimligi Fakultesi Dergisi 2015;25.
• 15. De Rouck T, Eghbali R, Collys K, De Bruyn H, Cosyn J. The gingival phenotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol 2009;36:428-33.
• 16. Malhotra R, Grover V, Bhardwaj A, Mohindra K. Analysis of the gingival phenotype based on the measurement of the dentopapillary complex. J Indian Soc Periodontol 2014;18:43-7.
• 17. Evans CD, Chen ST. Esthetic outcomes of immediate implant placements. Clin Oral Implants Res 2008;19:73-80.
• 18. Gastaldo JF, Cury PR, Sendyk WR. Effect of the vertical and horizontal distances between adjacent implants and between a tooth and an implant on the incidence of interproximal papilla. J Periodontol 2004;75:1242-6.
• 19. Eghbali A, De Rouck T, De Bruyn H, Cosyn J. The gingival phenotype assessed by experienced and inexperienced clinicians. J Clin Periodontol 2009;36:958-63.
• 20. Kheur MG, Kantharia NR, Kheur SM, et al. Three-dimensional evaluation of alveolar bone and soft tissue dimensions of maxillary central incisors for immediate implant placement: a cone-beam computed tomography assisted analysis. Implant Dent 2015;24:407-15.
• 21. Maynard JG, Jr, Wilson RD. Diagnosis and management of mucogingival problems in children. Dent Clin North Am 1980;24:683-703.
• 22. La Rocca AP, Alemany AS, Levi P, et al. Anterior maxillary and mandibular phenotype: relationship between gingival thickness and width with respect to underlying bone thickness. Implant Dent 2012;21:507-15.
• 23. Ronay V, Sahrmann P, Bindl A, Attin T, Schmidlin PR. Current status and perspectives of mucogingival soft tissue measurement methods. J Esthet Restor Dent 2011;23:146-56.
• 24. Cuny-Houchmand M, Renaudin S, Leroul M, et al. Gingival phenotype assessement: visual inspection relevance and maxillary versus mandibular comparison.Open Dent J 2013;7:1-6.
• 25. Muller HP, Heinecke A, Schaller N, Eger T. Masticatory mucosa in subjects with different periodontal phenotypes. J Clin Periodontol 2000;27:621-6.
• 26. Shah R, Sowmya NK, Mehta DS. Prevalence of gingival phenotype and its relationship to clinical parameters. Contemp Clin Dent 2015;6:167-71.
• 27. Nizam N, Akcali, A. Microsurgery in the treatment of gingival recessions: A review of the literature. J Dent Fac Ataturk University 2014;24:283-90.
• 28. Olsson M, Lindhe J, Marinello CP. On the relationship between crown form and clinical features of the gingiva in adolescents. J Clin Periodontol 1993;20:570-7.